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Video 1: This is a dynamic ultrasonography of normal individual. Posterosuperior labrum appears as a fibrillary hyperechoic triangle, coursing around the shoulder joint capsule. During the ABER maneuver, there was no detachment of labrum or joint fluid leakage, although the PS labrum was pressed slightly by the pressure from ABER posture.

Video 2: This is a dynamic ultrasonography of a 36-year-old man with posterosuperior labral tear. Although the PS labrum appears as a fibrillary hyperechoic triangle in neutral position, hypoechoic lesion is distinct in PS labrum. During the ABER maneuver, leakage of the joint fluid through torn PS labrum can be seen. In this case the fluid flow through the tear is admittedly a subtle finding and the presence of a GHJ effusion (not seen in this case) may make this examination more difficult.

Using a curvilinear transducer in the oblique coronal plane, and the probe is placed between the coracoid process and acromioclavicular joint. A hypoechoic slip inside the hyperechoic triangular labrum is identified. Proximal portion of the biceps tendon (long head) appeared intact. With forcefully pulling the arm downward, the slip was enlarged with fluid filling the gap.

This video demonstrates an ultrasound-guided 5-in-1 injection for trigger point injection in the trapezius, levator scapulae and rhomboid muscles, and nerve hydrodissection of the spinal accessory nerve and dorsal scapular nerve for a patient with upper back pain with neuropathic characteristics.

This video demonstrates needle electromyography on a patient with respiratory synkinesis, with a needle in the right biceps brachii muscle. The first section of the video shows a relaxed patient, with the appearance of motor units associated with the inhalation phase of breathing. Next, the electromyographer asks her to take a deep breath with subsequent activation of numerous atypical motor units, which is done three times. For the last section, the patient holds her breath, and the motor unit stops firing.

The video provides a brief background to the pa-tient’s presentation, management and follow up. This is accompanied by 2 clips showing the ultra-sound tracking of the affected posterior interosse-ous nerve and the sound side.

The video demonstrated tracking a swollen extensor carpi ulnaris tendon with a thickened retinaculum. An enlarged nerve segment with loss of fascicular echotexture was observed, and was impinged by the thickened retinaculum.

This video shows how ultrasound-guided cervical nerve root block (US-CRB) is done to the 5th nerve root level.
The objective of CRB is to place the needle in the intertubercular groove situated between the nerve root and the posterior tubercle.

Extensor Tendinopathy (Tennis Elbow) is a common term used to describe pathology of the forearm extensor tendons that converge to anchor the muscles to the lateral elbow. During traditional ultrasonography using the longitudinal scanning method, it is difficult to determine which component of the common extensor tendon (CET) is affected. This video presents the addition of a transverse scan to better visualize the tendons that join and form the CET. Two cases seen in our ultrasound clinic were demonstrated. The findings from the transverse scan helped to provide modifications of specific wrist and hand activities to facilitate recovery.

The image revealed a flattened compressible mass superficial to the flexor tendon on the 3rd metatarsophalangeal joint. Slightly relocating the transducer toward the heel, we found another mass emerging from the 3rd intermetatarsal space, a common region for Morton’s neuroma. Under dynamic tracking, the connecting stalk between the intermetatarsal mass and the lesion overlying the 3rd toe flexor tendon might be considered as another hint for tendon-sheath related pathology. Its heteroechoic appearance and hypervasculairty were compatible with submetatarsal bursitis.

Video 1: This is a dynamic ultrasonography of normal individual. Posterosuperior labrum appears as a fibrillary hyperechoic triangle, coursing around the shoulder joint capsule. During the ABER maneuver, there was no detachment of labrum or joint fluid leakage, although the PS labrum was pressed slightly by the pressure from ABER posture.

Video 2: This is a dynamic ultrasonography of a 36-year-old man with posterosuperior labral tear. Although the PS labrum appears as a fibrillary hyperechoic triangle in neutral position, hypoechoic lesion is distinct in PS labrum. During the ABER maneuver, leakage of the joint fluid through torn PS labrum can be seen. In this case the fluid flow through the tear is admittedly a subtle finding and the presence of a GHJ effusion (not seen in this case) may make this examination more difficult.

Using a curvilinear transducer in the oblique coronal plane, and the probe is placed between the coracoid process and acromioclavicular joint. A hypoechoic slip inside the hyperechoic triangular labrum is identified. Proximal portion of the biceps tendon (long head) appeared intact. With forcefully pulling the arm downward, the slip was enlarged with fluid filling the gap.

This video demonstrates an ultrasound-guided 5-in-1 injection for trigger point injection in the trapezius, levator scapulae and rhomboid muscles, and nerve hydrodissection of the spinal accessory nerve and dorsal scapular nerve for a patient with upper back pain with neuropathic characteristics.

This video demonstrates needle electromyography on a patient with respiratory synkinesis, with a needle in the right biceps brachii muscle. The first section of the video shows a relaxed patient, with the appearance of motor units associated with the inhalation phase of breathing. Next, the electromyographer asks her to take a deep breath with subsequent activation of numerous atypical motor units, which is done three times. For the last section, the patient holds her breath, and the motor unit stops firing.

The video demonstrated tracking a swollen extensor carpi ulnaris tendon with a thickened retinaculum. An enlarged nerve segment with loss of fascicular echotexture was observed, and was impinged by the thickened retinaculum.

Extensor Tendinopathy (Tennis Elbow) is a common term used to describe pathology of the forearm extensor tendons that converge to anchor the muscles to the lateral elbow. During traditional ultrasonography using the longitudinal scanning method, it is difficult to determine which component of the common extensor tendon (CET) is affected. This video presents the addition of a transverse scan to better visualize the tendons that join and form the CET. Two cases seen in our ultrasound clinic were demonstrated. The findings from the transverse scan helped to provide modifications of specific wrist and hand activities to facilitate recovery.

Ulnar nerve subluxation or snapping triceps syndrome is the condition of anterior sliding of the ulnar nerve or part of the triceps muscle over the
medial epicondyle during elbow flexion. This video presents the real-time dynamic visualization of the entire process of ulnar nerve subluxation and snapping triceps during joint movement of the elbow using ultrasonography.

Injection treatment to the glenohumeral joint is often needed to treat shoulder problems such as adhesive capsulitis. This can be done through blind palpation technique, fluoroscopic or musculoskeletal ultrasound guidance. In recent years, ultrasound has been proven to increase the accuracy of needle placement into the glenohumeral joint.
Glenohumeral joint injection can be done through the anterior rotator interval approach or the posterior approach techniques. The posterior injection technique offers an easier and a more effective approach to the glenohumeral joint with less extravasation rate as compared with the anterior approach. The video demonstrates how the posterior injection approach is done through ultrasound guidance.

The video shows dynamic ultrasound imaging for type A intrasheath subluxation of the peroneal tendons. Transposition of the peroneal longus and brevis tendons during ankle dorsiflexion and evertion is demonstrated.

This video shows the dynamic images for the iliotibial band snapping hip syndrome, which could not be detected by the MRI exam. If an individual has lateral hip pain and correlated history, dynamic ultrasound imaging is the best modality to diagnose iliotibial band snapping hip syndrome.

With the July issue of the Journal we are launching a new regular feature: the Video Gallery. The purpose of this Gallery is to combine text with video in the presentation and discussion of a topic of interest in musculoskeletal medicine. The first publication is authored by Chiang and collaborators who made a fantastic effort to write the text and produce the video in a relatively short period of time so we could include it in this issue of the Journal. This first “combined media publication” focus on the use of ultrasound for the examination of the rotator cuff and injection of the subacromial and subdeltoid bursa. Thanks to the effort of the Publisher LWW, the video can be accessed using your smartphone camera QR reader App to scan and capture the QR Code included with the print version of the article or by visiting our website at www.AJPMR.com. I hope you will appreciate this new feature and send us your comments and suggestions for future topics and use of electronic media.